Prophylactic Effectiveness of Phenylephrine 100 mcg and Ephedrine 10 mg on the Incidence of Spinal Anesthesia Induced Hypotension in Patients Undergoing Cesarean Section

Introduction: Birth by cesarean section (C-section) has increased significantly, with a high risk of maternal hypotension due to spinal anesthesia. Objective: This study aims to compare the prophylactic effectiveness of phenylephrine 100 mcg and ephedrine 10 mg in preventing spinal anaesthesia ind...

Full description

Saved in:
Bibliographic Details
Main Authors: Cassandra Etania, Achsanuddin Hanafie, Andriamuri Primaputra Lubis
Format: Article
Language:English
Published: Universitas Airlangga, Faculty of Medicine 2025-07-01
Series:Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Subjects:
Online Access:https://e-journal.unair.ac.id/IJAR/article/view/66056
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849727836485582848
author Cassandra Etania
Achsanuddin Hanafie
Andriamuri Primaputra Lubis
author_facet Cassandra Etania
Achsanuddin Hanafie
Andriamuri Primaputra Lubis
author_sort Cassandra Etania
collection DOAJ
description Introduction: Birth by cesarean section (C-section) has increased significantly, with a high risk of maternal hypotension due to spinal anesthesia. Objective: This study aims to compare the prophylactic effectiveness of phenylephrine 100 mcg and ephedrine 10 mg in preventing spinal anaesthesia induced hypotension in C-section patients. With a focus on safety and reducing the incidence of fetal acidosis, the results of the study are expected to provide clinical insights that can improve the safety and quality of care for pregnant women undergoing this procedure. Methods: This study compared the effectiveness of phenylephrine 100 mcg and ephedrine 10 mg in preventing hypotension due to spinal anesthesia in cesarean section patients in four hospitals in Medan, Indonesia. Using a double-blind design, 40 patients aged 18-40 years were randomly selected, and blood pressure and heart rate were measured before and after anesthesia. Data were analyzed using SPSS, and ethical aspects were taken care of through informed consent. Results: This study found that phenylephrine 100 mcg was more effective than ephedrine 10 mg in preventing spinal anaesthesia induced hypotension in cesarean section, with more stable blood pressure and mean arterial pressure (MAP) at the 5th, 10th, and 15th minutes (p-value < 0.05). Although ephedrine remained above 100 mmHg for systolic blood pressure (SBP), the incidence of nausea and vomiting was slightly higher in the ephedrine group. Results support phenylephrine as the primary choice for hypotensive management. Conclusion: Phenylephrine 100 mcg is more effective than ephedrine 10 mg in preventing hypotension due to spinal anesthesia, without increasing heart rate. Despite causing nausea, ephedrine has a higher incidence of vomiting. Ephedrine is recommended if phenylephrine is not available, with further studies needed for lower doses of phenylephrine.
format Article
id doaj-art-9ff0a747d25944a1b3b0a355ea68f6a1
institution DOAJ
issn 2722-4554
2686-021X
language English
publishDate 2025-07-01
publisher Universitas Airlangga, Faculty of Medicine
record_format Article
series Indonesian Journal of Anesthesiology and Reanimation (IJAR)
spelling doaj-art-9ff0a747d25944a1b3b0a355ea68f6a12025-08-20T03:09:44ZengUniversitas Airlangga, Faculty of MedicineIndonesian Journal of Anesthesiology and Reanimation (IJAR)2722-45542686-021X2025-07-0172859210.20473/ijar.V7I22025.85-9264224Prophylactic Effectiveness of Phenylephrine 100 mcg and Ephedrine 10 mg on the Incidence of Spinal Anesthesia Induced Hypotension in Patients Undergoing Cesarean SectionCassandra Etania0https://orcid.org/0009-0009-1843-8098Achsanuddin Hanafie1https://orcid.org/0000-0002-1389-4723Andriamuri Primaputra Lubis2https://orcid.org/0000-0002-1962-3799Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Sumatera Utara/H. Adam Malik General Hospital, MedanDepartment of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Sumatera Utara/H. Adam Malik General Hospital, MedanDepartment of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Sumatera Utara/H. Adam Malik General Hospital, MedanIntroduction: Birth by cesarean section (C-section) has increased significantly, with a high risk of maternal hypotension due to spinal anesthesia. Objective: This study aims to compare the prophylactic effectiveness of phenylephrine 100 mcg and ephedrine 10 mg in preventing spinal anaesthesia induced hypotension in C-section patients. With a focus on safety and reducing the incidence of fetal acidosis, the results of the study are expected to provide clinical insights that can improve the safety and quality of care for pregnant women undergoing this procedure. Methods: This study compared the effectiveness of phenylephrine 100 mcg and ephedrine 10 mg in preventing hypotension due to spinal anesthesia in cesarean section patients in four hospitals in Medan, Indonesia. Using a double-blind design, 40 patients aged 18-40 years were randomly selected, and blood pressure and heart rate were measured before and after anesthesia. Data were analyzed using SPSS, and ethical aspects were taken care of through informed consent. Results: This study found that phenylephrine 100 mcg was more effective than ephedrine 10 mg in preventing spinal anaesthesia induced hypotension in cesarean section, with more stable blood pressure and mean arterial pressure (MAP) at the 5th, 10th, and 15th minutes (p-value < 0.05). Although ephedrine remained above 100 mmHg for systolic blood pressure (SBP), the incidence of nausea and vomiting was slightly higher in the ephedrine group. Results support phenylephrine as the primary choice for hypotensive management. Conclusion: Phenylephrine 100 mcg is more effective than ephedrine 10 mg in preventing hypotension due to spinal anesthesia, without increasing heart rate. Despite causing nausea, ephedrine has a higher incidence of vomiting. Ephedrine is recommended if phenylephrine is not available, with further studies needed for lower doses of phenylephrine.https://e-journal.unair.ac.id/IJAR/article/view/66056cesarean sectionephedrinehypotensionphenylephrinespinal anaesthesia
spellingShingle Cassandra Etania
Achsanuddin Hanafie
Andriamuri Primaputra Lubis
Prophylactic Effectiveness of Phenylephrine 100 mcg and Ephedrine 10 mg on the Incidence of Spinal Anesthesia Induced Hypotension in Patients Undergoing Cesarean Section
Indonesian Journal of Anesthesiology and Reanimation (IJAR)
cesarean section
ephedrine
hypotension
phenylephrine
spinal anaesthesia
title Prophylactic Effectiveness of Phenylephrine 100 mcg and Ephedrine 10 mg on the Incidence of Spinal Anesthesia Induced Hypotension in Patients Undergoing Cesarean Section
title_full Prophylactic Effectiveness of Phenylephrine 100 mcg and Ephedrine 10 mg on the Incidence of Spinal Anesthesia Induced Hypotension in Patients Undergoing Cesarean Section
title_fullStr Prophylactic Effectiveness of Phenylephrine 100 mcg and Ephedrine 10 mg on the Incidence of Spinal Anesthesia Induced Hypotension in Patients Undergoing Cesarean Section
title_full_unstemmed Prophylactic Effectiveness of Phenylephrine 100 mcg and Ephedrine 10 mg on the Incidence of Spinal Anesthesia Induced Hypotension in Patients Undergoing Cesarean Section
title_short Prophylactic Effectiveness of Phenylephrine 100 mcg and Ephedrine 10 mg on the Incidence of Spinal Anesthesia Induced Hypotension in Patients Undergoing Cesarean Section
title_sort prophylactic effectiveness of phenylephrine 100 mcg and ephedrine 10 mg on the incidence of spinal anesthesia induced hypotension in patients undergoing cesarean section
topic cesarean section
ephedrine
hypotension
phenylephrine
spinal anaesthesia
url https://e-journal.unair.ac.id/IJAR/article/view/66056
work_keys_str_mv AT cassandraetania prophylacticeffectivenessofphenylephrine100mcgandephedrine10mgontheincidenceofspinalanesthesiainducedhypotensioninpatientsundergoingcesareansection
AT achsanuddinhanafie prophylacticeffectivenessofphenylephrine100mcgandephedrine10mgontheincidenceofspinalanesthesiainducedhypotensioninpatientsundergoingcesareansection
AT andriamuriprimaputralubis prophylacticeffectivenessofphenylephrine100mcgandephedrine10mgontheincidenceofspinalanesthesiainducedhypotensioninpatientsundergoingcesareansection